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Article: Recent management of endometrial cancer: a narrative review of the literature.

Pados, George / Zouzoulas, Dimitrios / Tsolakidis, Dimitrios

2024 Volume 10, Page(s) 1244634

Abstract: Endometrial cancer is a common female gynecological neoplasia and its incidence rate has increased in the past years. Due to its predominant symptoms, most women will present uterine bleeding. It is usually diagnosed at an early stage and surgery has an ... ...

Abstract	Endometrial cancer is a common female gynecological neoplasia and its incidence rate has increased in the past years. Due to its predominant symptoms, most women will present uterine bleeding. It is usually diagnosed at an early stage and surgery has an important role in the treatment plan. The prognosis and quality of life of these patients can be quite favorable, if proper treatment is offered by surgeons. Traditionally, more invasive approaches and procedures were offered to these patients, but recent data suggest that more conservative and minimal invasive choices can be adopted in the treatment algorithm. Minimal invasive surgery, such as laparoscopy and robotic surgery, should be considered as an acceptable alternative, compared to laparotomy with less comorbidities and similar oncological and survival outcomes. Furthermore, sentinel lymph node biopsy has emerged in the surgical staging of endometrial cancer, in order to replace comprehensive lymphadenectomy. It is associated with less intra- and postoperative complications, while preliminary data show no difference in survival rates. However, sentinel lymph node biopsy should be offered within a strict algorithm, to avoid residual metastatic disease. The aim of this review is to analyze all the available data for the application of minimal invasive surgery in early endometrial cancer and especially the role of sentinel lymph node biopsy.
Language	English
Publishing date	2024-01-03
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2023.1244634
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Article: Diagnosis of Endometriosis by Transvaginal Ultrasound: An Online Survey of Gynecologists Practising in Greece.

Grigoriadis, Georgios / Roman, Horace / Kalaitzopoulos, Dimitrios R / Christoforidis, Nikos / Pados, George / Daniilidis, Angelos

Cureus

2023 Volume 15, Issue 4, Page(s) e37950

Abstract: Accurate diagnosis and assessment of endometriosis by transvaginal ultrasound scan (TVS) can be challenging. We performed an online survey of specialist gynecologists who perform TVS on a regular basis regarding their views as well as clinical experience ...

Abstract	Accurate diagnosis and assessment of endometriosis by transvaginal ultrasound scan (TVS) can be challenging. We performed an online survey of specialist gynecologists who perform TVS on a regular basis regarding their views as well as clinical experience on the use of TVS in the diagnosis of endometrioma and deep endometriosis (DE). We collected 64 responses. Sixty-one participants (95.31%) answered that they can confidently diagnose endometrioma by TVS "always" or "most of the time". With the exception of DE of the recto-vaginal septum/posterior vaginal vault, for all other DE locations, more than 50% of participants felt that they can "rarely" or "never" diagnose it by TVS in their own clinical practice. Forty-two participants (65.6%) stated that additional, specialized training is required for the diagnosis of endometrioma. When asked about a diagnosis of DE, 58 participants (90.6%) felt that the same is required. The only statistically significant association was between the number of TVSs performed per year and the clinician's ability to diagnose bowel DE in their practice. The answers to all other questions did not differ significantly based on professional status, years of experience post-residency, or number of TVSs per year. Our results demonstrate the delayed adoption of novel diagnostic approaches in endometriosis and confirm the urgent need for specialized ultrasound training.
Language	English
Publishing date	2023-04-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.37950
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Article ; Online: Adenomyosis and Infertility: A Literature Review.

Pados, George / Gordts, Stephan / Sorrentino, Felice / Nisolle, Michelle / Nappi, Luigi / Daniilidis, Angelos

Medicina (Kaunas, Lithuania)

2023 Volume 59, Issue 9

Abstract: Background and ... ...

Abstract	Background and Objectives
MeSH term(s)	Female ; Pregnancy ; Humans ; Adenomyosis/complications ; Infertility, Female/epidemiology ; Infertility, Female/etiology ; Fertility ; Fertilization in Vitro ; Abortion, Spontaneous
Language	English
Publishing date	2023-08-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina59091551
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Article ; Online: Pregnancy-Related Hysterectomy for Peripartum Hemorrhage: A Literature Narrative Review of the Diagnosis, Management, and Techniques.

Tsolakidis, Dimitrios / Zouzoulas, Dimitrios / Pados, George

BioMed research international

2021 Volume 2021, Page(s) 9958073

Abstract: Postpartum hemorrhage is a life-threatening situation, in which hysterectomy can be performed to prevent maternal death. However, it is associated with high rates of maternal morbidity and mortality and permanent infertility. The incidence of pregnancy- ... ...

Abstract	Postpartum hemorrhage is a life-threatening situation, in which hysterectomy can be performed to prevent maternal death. However, it is associated with high rates of maternal morbidity and mortality and permanent infertility. The incidence of pregnancy-related hysterectomy varies across countries, but its main indications are the following: uterine atony and placenta spectrum (PAS) disorders. PAS disorder prevalence is rising during the last years, mainly due to the increased number of cesarean sections. As a result, obstetricians should be aware of the difficulties of this emergent condition and improve its accurate antenatal diagnosis rates, as well as its modern management strategies. Of course, special skills are required during a pregnancy-related hysterectomy, so these patients should be referred to centers of excellence in antenatal care, where a multidisciplinary team approach is followed. This study is a narrative review of the literature of the last 5 years (PubMed, Cochrane) regarding postpartum hemorrhage to offer obstetricians up-to-date knowledge on this pregnancy-related life-threatening issue. However, there is a lack of available high-quality data, because most published papers are retrospective case series or observational cohorts.
MeSH term(s)	Female ; Humans ; Hysterectomy ; Peripartum Period ; Placenta Diseases/surgery ; Postpartum Hemorrhage/diagnosis ; Postpartum Hemorrhage/physiopathology ; Postpartum Hemorrhage/surgery ; Pregnancy ; Risk Factors
Language	English
Publishing date	2021-07-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2698540-8
ISSN	2314-6141 ; 2314-6133
ISSN (online)	2314-6141
ISSN	2314-6133
DOI	10.1155/2021/9958073
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Article ; Online: Role of laparoscopic hysterectomy in cervical and endometrial cancer: a narrative review.

Gitas, Georgios / Pados, George / Laganà, Antonio Simone / Guenther, Veronika / Ackermann, Johannes / Alkatout, Ibrahim

Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy

2022 Volume 32, Issue 1, Page(s) 1–11

Abstract: Endometrial cancer is the most common carcinoma of the female genital organs and cervical cancer is the leading cause of cancer death in women worldwide. The aim of this review is to evaluate the role of laparoscopic hysterectomy in patients with ... ...

Abstract	Endometrial cancer is the most common carcinoma of the female genital organs and cervical cancer is the leading cause of cancer death in women worldwide. The aim of this review is to evaluate the role of laparoscopic hysterectomy in patients with endometrial and cervical cancer in this period, and analyze the outcome of hysterectomy in terms of survival. Moreover, we present the historical background, new techniques, the anatomical features, and surgical steps of radical hysterectomy. According to new evidence, minimally invasive surgery in patients with cervical cancer is associated with higher rates of recurrence and mortality compared to the open approach. Despite the numerous explanations offered for this phenomenon, the reasons for these results are unclear. Additional large trials have been launched to reevaluate the above-mentioned data. On contrary, the laparoscopic approach provides surgical outcomes and similar survival rates as open surgery in patients with early endometrial carcinoma. Furthermore, the radicality of hysterectomy does not influence local recurrence rates or overall survival in cases with complete surgical removal of the tumor. A laparoscopic radical hysterectomy is no longer an option in patients with cervical cancer. When minimally invasive surgery is offered, the patients must be counseled in detail about the current debate.
MeSH term(s)	Female ; Humans ; Uterine Cervical Neoplasms/surgery ; Neoplasm Staging ; Minimally Invasive Surgical Procedures ; Endometrial Neoplasms/surgery ; Endometrial Neoplasms/pathology ; Hysterectomy/methods ; Laparoscopy/methods ; Retrospective Studies
Language	English
Publishing date	2022-12-13
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1317160-4
ISSN	1365-2931 ; 1364-5706
ISSN (online)	1365-2931
ISSN	1364-5706
DOI	10.1080/13645706.2022.2154166
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Zs.A 3467: Show issues

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Article: Rate of Leiomyosarcomas during Surgery for Uterine Fibroids: 8-Year Experience of a Single Center.

Zouzoulas, Dimitrios / Tsolakidis, Dimitrios / Pavlidi, Olga I / Pappas, Panagiotis D / Theodoridis, Theodoros / Pados, George / Pervana, Stavroula / Pazarli, Elsa / Grimbizis, Grigoris

Journal of clinical medicine

2023 Volume 12, Issue 24

Abstract: The aim of this study is to investigate the prevalence of occult malignant mesenchymal tumors in patients operated on for uterine fibroids in relation to the surgical approach and type of operation. A retrospective review of all patients that underwent ... ...

Abstract	The aim of this study is to investigate the prevalence of occult malignant mesenchymal tumors in patients operated on for uterine fibroids in relation to the surgical approach and type of operation. A retrospective review of all patients that underwent surgery for uterine fibroids (January 2011-December 2018) at the 1st Department of Obstetrics & Gynecology at "Papageorgiou" Hospital. The surgical approach and clinicopathological characteristics were analyzed. A total of 803 patients were operated on: 603 (75.1%) with laparotomy, 187 (23.3%) laparoscopically, and 13 (1.6%) vaginally. Furthermore, 423 (52.7%) patients underwent hysterectomy and 380 (47.3%) myomectomies. Laparoscopy and myomectomy were offered to younger patients with fewer smaller uterine fibroids and were associated with statistically significant shorter hospitalization. The pathological reports revealed: 690 (86%) benign leiomyomas, 32 (4%) cellular leiomyomas, 29 (3.6%) degenerated leiomyomas, 22 (2.7%) adenomyomas, 18 (2.2%) atypical-bizarre leiomyomas, 1 (0.1%) STUMP, 5 (0.65%) endometrial stromal sarcomas, and 6 (0.75%) cases of leiomyosarcomas (LMS). All LMS were preoperatively characterized as suspicious and underwent abdominal hysterectomy. Morcellation was offered in two cases of atypical leiomyomas, with no morcellation-associated complication. Laparoscopy as a valuable surgical approach for young patients with fewer in number and smaller in size fibroids is associated with shorter hospitalization. The risk of unintended morcellation of LMS seems to be very low and can be reduced with careful preoperative work-up but not eliminated.
Language	English
Publishing date	2023-12-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12247555
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Article ; Online: Comments on the ESHRE recommendations for the treatment of minimal endometriosis in infertile women.

Daniilidis, Angelos / Pados, George

Reproductive biomedicine online

2017 Volume 36, Issue 1, Page(s) 84–87

Abstract: According to ESHRE recommendations for women with stage I/II endometriosis, if a decision is made to proceed to laparoscopy then operative laparoscopy (excision or ablation of the endometriotic lesions) should be performed rather than only diagnostic ... ...

Abstract	According to ESHRE recommendations for women with stage I/II endometriosis, if a decision is made to proceed to laparoscopy then operative laparoscopy (excision or ablation of the endometriotic lesions) should be performed rather than only diagnostic laparoscopy, to increase ongoing pregnancy rates. Also, for infertile women with stage I/II endometriosis doctors may consider complete surgical removal of endometriosis to improve live birth rate prior to assisted reproductive treatment. This last recommendation is not well established. Does laparoscopic treatment of minimal endometriosis increase the fertility of women with minimal endometriosis? Should we perform surgery in all cases of minimal endometriosis to improve reproductive outcomes prior to assisted reproductive treatment? The aim of this article is to present evidence on these two questions and comment on the ESHRE recommendations. Evidence is quite robust that laparoscopic destruction of minimal to mild endometriosis and associated adhesions enhances fecundity. On the other hand, to date no clear benefit has been demonstrated of performing laparoscopy for minimal endometriosis in women undergoing IVF/intracytoplasmic sperm injection, therefore it is not recommended in these cases. Further studies are needed to assess the mechanisms of endometriosis-associated infertility and how it may be overcome in cases of minimal and mild endometriosis.
MeSH term(s)	Endometriosis/complications ; Endometriosis/surgery ; Female ; Humans ; Infertility, Female/etiology ; Infertility, Female/surgery ; Practice Guidelines as Topic
Language	English
Publishing date	2017-10-23
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2113823-0
ISSN	1472-6491 ; 1472-6483
ISSN (online)	1472-6491
ISSN	1472-6483
DOI	10.1016/j.rbmo.2017.10.103
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Zs.A 5792: Show issues

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Article: Endometrial changes in estrogen and progesterone receptor expression during implantation in an oocyte donation program.

Klonos, Eleftherios / Katopodis, Periklis / Karteris, Emmanouil / Papanikolaou, Evangelos / Tarlatzis, Basil / Pados, George

Experimental and therapeutic medicine

2020 Volume 20, Issue 6, Page(s) 178

Abstract: Implantation is the final and most important stage of embryogenesis and is of paramount importance in achieving a successful pregnancy. Progesterone and estrogen are steroid hormones responsible for the regulation of the implantation window and the ... ...

Abstract	Implantation is the final and most important stage of embryogenesis and is of paramount importance in achieving a successful pregnancy. Progesterone and estrogen are steroid hormones responsible for the regulation of the implantation window and the current study hypothesised that their receptors may be implicated in women undergoing oocyte donation. A total of 15 women aged 25-32 years old (mean ± SD, 28.9±2.89) undergoing oocyte donation were recruited into the present study. Participants underwent ovarian stimulation with gonadotrophin-releasing hormone antagonist and recombinant follicle-stimulating hormone. Endometrial aspiration biopsy was performed on the day of oocyte retrieval and after 5 days (on days 0 and 5, respectively). Endometrial histology and evaluation of estrogen receptor (ER)α and progesterone receptor (PR)-B were performed on days 0 and 5. The ER nodal staining percentage on day 0 was age-associated, with patients aged <30 years demonstrating 100% staining and those aged >30 years exhibiting 90% staining. Pathological staining revealed statistically significant differences between days 0 and 5 following all staining procedures. Wilcoxon signed-rank test resulted in the following P-values, for ER (nodes % and stromal %) day 0/5, P=0.0001; for PR (nodes % and stromal %) day 0/5, P=0.0001 and P=0.035, respectively; for ER (grade nodes and stromal %) day 0/5, P=0.0001; and PR (grade nodes and stromal %) day 0/5 P=0.0001 and P=0.016, respectively. Synchronization between blastocyst development and the acquisition of endometrial receptivity is a prerequisite for the success of
Language	English
Publishing date	2020-10-12
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2683844-8
ISSN	1792-1015 ; 1792-0981
ISSN (online)	1792-1015
ISSN	1792-0981
DOI	10.3892/etm.2020.9308
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Article ; Online: Reproductive outcome after operative hysteroscopy for uterine septum: scissors or diathermy?

Daniilidis, Angelos / Kalpatsanidis, Antonis / Kalkan, Uzeyir / Kasmas, Stamatis / Pados, George / Angioni, Stefano

Minerva ginecologica

2020 Volume 72, Issue 1, Page(s) 36–42

Abstract: Introduction: Hysteroscopic septoplasty is a safe and routinely used procedure for the treatment of septate uterus. The aim of this paper is to determine which hysteroscopic technique (scissors, monopolar/bipolar diathermy) is superior for post- ... ...

Abstract	Introduction: Hysteroscopic septoplasty is a safe and routinely used procedure for the treatment of septate uterus. The aim of this paper is to determine which hysteroscopic technique (scissors, monopolar/bipolar diathermy) is superior for post-treatment reproductive outcome. Evidence acquisition: Two different hysteroscopic septoplasty instruments (scissors and monopolar/bipolar diathermy) were compared, focusing on the pregnancy outcome. In addition, all published studies and reviews regarding pregnancy outcomes that occurred after operative hysteroscopy using different techniques (bipolar, monopolar electrodes, resectoscope, VERSAPOINT™ [Ethicon LLC] and scissors) were reviewed. Dichotomous analysis, with use of the Mantel-Haenszel method, was performed for all five outcomes, with fixed effect analysis model and odds ratio (OR) as the effect measure. Analysis details included totals and subtotals with 95% confidence interval. The Multinomial CI package for the R statistical language was also used. Evidence synthesis: Out of 26 full-text articles available in the literature, two studies were finally selected as eligible, with a total number of 125 patients. Pregnancy rate for scissors was 88.8% and for resectoscope was 75.6% (OR: 2.13, I2=29%; P=0.23). Delivery rate for scissors was 78.1% and for resectoscope was 75.0% (OR: 1.29, I2=0%; P=0.53). Miscarriage rate for scissors was 21.8% and for resectoscope was 27.1% (OR: 0.78, I2=0%; P=0.53). Preterm delivery rate for scissors was 6.2% and for resectoscope was 6.7% (OR: 0.85, I2=0%; P=0.94). Term delivery rate for scissors was 71.8% and for resectoscope was 66.1% (OR: 1.32, I2=0%; P=0.47). The lack of evidence in literature regarding the potential influence in the reproductive outcome of the instrument used when performing a hysteroscopy to treat a septate uterus became radically clear. Conclusions: No statistically significant differences were observed in reproductive outcomes between women treated for septate uterus using resectoscope or scissors.
MeSH term(s)	Abortion, Spontaneous/epidemiology ; Confidence Intervals ; Diathermy/instrumentation ; Diathermy/methods ; Female ; Humans ; Hysteroscopy/instrumentation ; Hysteroscopy/methods ; Odds Ratio ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Premature Birth/epidemiology ; Surgical Instruments/adverse effects ; Term Birth ; Treatment Outcome ; Uterus/abnormalities ; Uterus/surgery
Language	English
Publishing date	2020-03-10
Publishing country	Italy
Document type	Comparative Study ; Journal Article ; Systematic Review
ZDB-ID	80159-8
ISSN	1827-1650 ; 0026-4784 ; 0325-8793
ISSN (online)	1827-1650
ISSN	0026-4784 ; 0325-8793
DOI	10.23736/S0026-4784.20.04444-5
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Article ; Online: A pancancer overview of FBN1, asprosin and its cognate receptor OR4M1 with detailed expression profiling in ovarian cancer.

Kerslake, Rachel / Hall, Marcia / Vagnarelli, Paola / Jeyaneethi, Jeyarooban / Randeva, Harpal S / Pados, George / Kyrou, Ioannis / Karteris, Emmanouil

Oncology letters

2021 Volume 22, Issue 3, Page(s) 650

Abstract: Ovarian cancer affects >295,000 women worldwide and is the most lethal of gynaecological malignancies. Often diagnosed at a late stage, current research efforts seek to further the molecular understanding of its aetiopathogenesis and the development of ... ...

Abstract	Ovarian cancer affects >295,000 women worldwide and is the most lethal of gynaecological malignancies. Often diagnosed at a late stage, current research efforts seek to further the molecular understanding of its aetiopathogenesis and the development of novel biomarkers. The present study investigated the expression levels of the glucogenic hormone asprosin [encoded by fibrillin-1 (
Language	English
Publishing date	2021-07-09
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2573196-8
ISSN	1792-1082 ; 1792-1074
ISSN (online)	1792-1082
ISSN	1792-1074
DOI	10.3892/ol.2021.12911
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